Category: Healthcare

Between Michael Mooreâ€™s â€œSicko,â€ and an election cycle in which the American people are naming healthcare as their number two issue (after the war in Iraq), American healthcare is about to undergo a long overdue and hopefully deep examination. If, however, all we do is focus on access to and payment for care â€” arguing, as Moore admirably does, for the elimination of private health insurance â€” then it is likely that the status quo will prevail, because the insurance companies will win that battle.

Remember, the insurance industry is a major contributor to and thus owner of the Congress. The men and women who make up the Senate and House are beholden to the industry for much of their financing yet, ironically enough, not for their own healthcare. Instead, all of the people who run the government (executive, legislative and judiciary) get their care through a government-run and -financed, single-payer, universal (for them) system.

We have to appreciate their conundrum when they get together to decide what to do about the rest of us â€” the fifty million who have no insurance at all, and many others who have the sort of tragically inadequate insurance that Moore highlights.

First, they canâ€™t exactly relate â€” they have fantastic healthcare! Second, if they try to provide for us what weâ€™re providing for them, their owners will stop sending all those big checks.

This is why the Clintonsâ€™ attempt at major reform stalled: though strong majorities of Americans then as now favored a switch to a single-payer, universal system, the nationâ€™s wealthy elites would not be moved. Nothing changed, except, of course, things got worse.

This time, if we want to get it right, we need to look not just at how we pay for healthcare, but at the actual care. We need to revolutionize the way medicine is practiced, moving away from our expensive, invasive, technology- and drug-based systemÂ to the sort of low-tech, people-centered, common sense care practiced in Cuba and other countries that are out-performing America.

Alas, this means stepping on the toes (and bottom-lines) of yet more wealthy elites â€” the doctors and pharmaceutical companies. So the only thing that will change is that in a couple years weâ€™ll have another ten or twenty million people without insurance, while standard medical practices will have grown yet more expensive.

The sharp knives are out for Michael Moore once again and, as with his past films, some of the sharpest are in the hands of democrats. This time the friendly fire is coming mostly from presidential contenders, who all want to sound like they’re serious about achieving universal coverage, but are floating plans that avoid the real issues.

Sens. Hillary Rodham Clinton of New York and Barack Obama of Illinois and former Sen. John Edwards of South Carolina all have staked out positions sharply at odds with Mooreâ€™s approach. But none of them is eager to have that fact dragged into the spotlight.

If Mooreâ€™s fire-breathing proposal catches on among party activists, who tend to be suspicious of the private sector and supportive of direct government action, the candidatesâ€™ pragmatic, consensus-seeking ideas could look like weak-kneed temporizing â€” much the way their rejection of an immediate pullout from Iraq has drawn heated criticism from antiwar activists.

In â€œSicko,â€ the filmmaker calls for abolishing the insurance industry, putting a tight regulatory collar on pharmaceutical companies and embracing a Canadian-style government-run system.

Rather than welcome Moore’s contribution to the conversation, his detractors are accusing him of advocating “socialized medicine” and hoping that such time-tested commie-baiting is enough to make him go away. The irony is that socialized medicine is just what we need â€” not “socialized” as in the way the Soviet Union used to do things, but “socialized” as in medicine practiced with a social conscience.

Our current system is the very opposite: mal-socialized medicine. It breaks American society into 250 million private actors all competing for a piece of a woefully limited healthcare pie. It is bound to create winners and losers, to stratify American culture, and to exacerbate the already difficult conditions of the poor and middle class.

The problem is that the U.S. corporate health insurance system, the corporate-dominated economy more generally, and the ideology that undergirds both, seeks to defeat the essential insurance function of sharing risk â€” of everyone helping to take care of everyone else.

Moore offers this challenge, or plea: â€œIf there is a better way to treat the sick simply by being good to each other why canâ€™t we do that?â€

People in the other countries visited in the film â€œlive in a world of we, not me,â€ says Moore.

To varying degrees, they have created solidarity societies, and they are happier, and healthier, for it.

The only thing more depressing than listening to our political and pundit classes soundbite their ways around the subject of the war in Iraq without every addressing the core issue of America’s addiction to Middle Eastern oil, is listening to their plans to reform the American healthcare system. Blah, blah, yak, yak, nothing ever changes, and the core problem with healthcare in America is never mentioned:

And these health insurance companies are — they’re just — they’re the Halliburtons of the health industry. I mean, they really — they get away with murder. They charge whatever they want. There’s no government control. And frankly, we will not really fix our system until we remove these private insurance companies. I mean, they literally have to be eliminated. They cannot be allowed to exist in this country.

Takes Michael Moore to say it because, unlike all of the people running the country, he’s not on the payroll of the insurance and pharmaceutical corporations. Also, he has no illusions about the limitations of free-market capitalism:

We have an economic system, as I’ve said before, it’s unjust, it’s unfair, it’s not democratic. And until, ultimately, that changes, until we construct a different form of economy in a way that we relate to capital, I don’t think that — I think we’ll continue to have these problems, where the have-nots suffer and the haves make off like bandits.

This is the heart of our conundrum: our economic system is killing us, but the people in charge are all winners in that system, so nothing ever changes.

Being America means never having to learn from other countries. Despite massive evidence that virtually every developed nation in the world has a better healthcare system than America, Americans dismiss them all with the no-think “socialized medicine” and carry on with a system that just gets worse with every passing year. So, there’s no chance that we will learn anything at all from Sarah Van Gelder’s exploration of Cuban healthcare, but it’s still a good read:

House calls are routine, in part because it’s the responsibility of the doctor and nurse team to understand you and your health issues in the context of your family, home, and neighborhood. This is key to the system. By catching diseases and health hazards before they get big, the Cuban medical system can spend a little on prevention rather than a lot later on to cure diseases, stop outbreaks, or cope with long-term disabilities. When a health hazard like dengue fever or malaria is identified, there is a coordinated nationwide effort to eradicate it. Cubans no longer suffer from diphtheria, rubella, polio, or measles and they have the lowest AIDS rate in the Americas, and the highest rate of treatment and control of hypertension.

For health issues beyond the capacity of the neighborhood doctor, polyclinics provide specialists, outpatient operations, physical therapy, rehabilitation, and labs. Those who need inpatient treatment can go to hospitals; at the end of their stay, their neighborhood medical team helps make the transition home. Doctors at all levels are trained to administer acupuncture, herbal cures, or other complementary practices that Cuban labs have found effective. And Cuban researchers develop their own vaccinations and treatments when medications aren’t available due to the blockade, or when they don’t exist.

Most important is the idea of medical care in the homes and neighborhoods, with friends and neighbors providing care. Socialized medicine, indeed.

Cubans say they offer health care to the worldâ€™s poor because they have big hearts. But what do they get in return?

They live longer than almost anyone in Latin America. Far fewer babies die. Almost everyone has been vaccinated, and such scourges of the poor as parasites, TB, malaria, even HIV/AIDS are rare or non-existent. Anyone can see a doctor, at low cost, right in the neighborhood.

The Cuban health care system is producing a population that is as healthy as those of the worldâ€™s wealthiest countries at a fraction of the cost. And now Cuba has begun exporting its system to under-served communities around the worldâ€”including the United States.

The story of Cubaâ€™s health care ambitions is largely hidden from the people of the United States, where politics left over from the Cold War maintain an embargo on information and understanding. But it is increasingly well-known in the poorest communities of Latin America, the Caribbean, and parts of Africa where Cuban and Cuban-trained doctors are practicing.

In the words of Dr. Paul Farmer, Cuba is showing that â€œyou can introduce the notion of a right to health care and wipe out the diseases of poverty.â€

“Our study clearly suggests that the respiratory effects of marijuana use can be decreased by use of a vaporizer,” Earleywine commented. “In fact, because we only asked participants about their primary means of using marijuana, it’s likely that people who exclusively use vaporizers will get even more benefit than our results indicate, because no doubt some in our study used vaporizers most of the time but not all of the time.”

In a rational world, the government officials objecting to medical marijuana based on the health risks of smoking would greet this research with open arms. They would join with groups like the Marijuana Policy Project in spreading the word about this important, health-enhancing technology.